• Title/Summary/Keyword: 천식악화

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Asthma Worsening factors of Adolescent Asthma Patients in Korea -Associated with Intake of Antioxidant Food- (청소년 천식 환자의 천식 악화의 영향 요인 -항산화식이 섭취와 관련하여-)

  • Park, In Sook;Yun, Hee Kyung
    • Journal of Digital Convergence
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    • v.15 no.6
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    • pp.297-304
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    • 2017
  • The purpose of this study was to investigate the association between antioxidant food intake pattern and asthma control status in Korean adolescents. This study was conducted using data from 1,578 patients diagnosed with asthma among the participants in the 11th online health behavior survey. Statistical analyses were performed for sociodemographic variables, known risk factors for asthma worsening, and all variables which were related to food intake pattern. For final decision, logistic regression analysis was used to estimate the associations between antioxidant food intake and asthma worsening. Male gender and smoking experiences were associated with asthma exacerbation. Low intake of antioxidant foods status also significantly increased asthma exacerbations. Antioxidant food intake and smoking prevention education is important for adolescent asthma patients. It is highly needed to recommend taking fruits and vegetables properly.

Clinical Investigation of Women with Asthma Worsened During Pregnancy (임신 중 천식의 악화로 내원한 환자의 임상적 고찰)

  • Kwon, Young-Hwan;Kim, Kyung-Kyu;Jung, Hye-Cheol;Lee, Sung-Yong;Kim, Je-Hyeong;Lee, So-Ra;Lee, Sang-Yeub;Lee, Sin-Hyeong;Cho, Jae-Yun;Shim, Jae-Jeong;Kang, Kyung-Ho;Yoo, Se-Hwa;In, Kwang-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.4
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    • pp.548-554
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    • 1999
  • Background : Asthma is the most common respiratory crisis encountered in clinical practice, occurring in up to 4% of all pregnancies. Pregnancy often appears to alter the course of asthma. But the mechanisms responsible for variable changes in the asthma course during pregnancy remain unknown. Poor control and exacerbations of asthma during pregnancy may result in serious maternal and fetal complications. To investigate the course of asthma during pregnancy in korean women, we did a retrograde study of 27 pregnant women who had been admitted to Korea University Hospital for asthma worsened. Method: Twenty seven pregnant women who had been visited to Korea University Hospital for asthma worsened were enrolled in our retrospective study. We reviewed medical recordings and interviewed patients with asthma. Results: Twenty seven pregnant women with asthma were evaluated, and 25 patients were enrolled to our study. Two patients experienced abortions at 6 weeks and 25 weeks gestation, respectively. The period of asthma worsened was commonly during weeks 20 to 28 of gestation. And all patients wosened were improved during the last 4 weeks of pregnancy. Twenty(80%) of 25 women whose asthma worsened during pregnancy reverted toward their prepregnancy status after delivery(p<0.002). The causes of asthma worsened during pregnancy are reduction or even complete cessaton of medication due to fears about its safety(40%), worsening after upper respiratory infection (28%), and unknown(32%). There were no adverse perinatal outcomes in 25 pregnant asthma subjects. Conclusions: A major problem of therapy for asthma during pregnancy is reduction or even complete cessation of medication due to fears of fetal effects. Therefore, maternal education and optimal clinical and pharmacologic management is necessary to mitigate maternal and fetal complications.

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Association of Plasma Eotaxin with Asthma Exacerbation and Severity (혈장 eotaxin과 천식의 급성악화 및 중증도와의 연관성)

  • Song, So-Hyang;Lee, So-Young;Kim, Chi-Hong;Moon, Hwa-Sik;Song, Jeong-Sup;Park, Sung-Hak
    • Tuberculosis and Respiratory Diseases
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    • v.51 no.1
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    • pp.35-43
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    • 2001
  • Background : The eosinophil chemotactic and activating effects of eotaxin and the known association of eosinophils with asthma suggest that eotaxin expression is increased during an asthma attack. This study was aimed to determine whether the plasma eotaxin levels are higher in patients during an asthma attack and to correlate the eotaxin levels with the disease activity, severity and response to therapy. Method : A case-control study of the plasma eotaxin levels was performed in 100 patients with exacerbated asthma and 48 age- and sex-matched subjects with stable asthma. Results : The plasma eotaxin levels were significantly higher in the 100 patients with exacerbated asthma($233{\pm}175\;pg/mL$) than in the 48 subjects with stable asthma($169{\pm}74\;pg/mL$). A trend toward higher eotaxin levels was observed in asthmatic subjects who were taking oral steroids ($332{\pm}225\;pg/mL$) than in those who were not ($214{\pm}159\;pg/mL$) and higher levels were found in those admitted to the hospital ($275{\pm}212\;pg/mL$) than in those discharged after receiving only emergency treatment ($190{\pm}115\;pg/mL$). The eotaxin levels inversely correlated with the $FEV_$ (r=-0.25, p<0.01). The eotaxin levels were higher in moderate persistent ($323{\pm}256\;pg/mL$) and severe persistent asthmatics ($276{\pm}170\;pg/mL$) than in mild intermittent asthmatics ($l60{\pm}60\;pg/mL$). Conclusion : Eotaxin expression is directly associated with asthma exacerbation, impaired pulmonary function and the disease severity.

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Changes in Plasma and Urine Endothelin Levels During Acute Exacerbation of Asthma (급성 천식발작시 혈장 및 요중 Endothelin 농도 변동)

  • Chang, Jung-Hyun;Shin, Tae-Rim;Woo, Ga-Eun;Kim, Jong-Seon;Hong, Eun-Soon;Seo, Gi-Yeoul;Cha, Joo-Hyun;Kim, Mi-Seon;Kim, Yeung-Seon;Cho, Young-Joo
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.4
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    • pp.844-852
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    • 1997
  • Background : Recent studies have documented increased release of endothelin(ET) during acute attack of asthma. The purpose of this study is to observe the link between plasma level and urinary excretion of each and changes during acute exacerbation. Method : Plasma and 24 hour urine were collected from sixteen asthmatics during acute exacerbation, twice ; first day of symptomatic exacerbation and two weeks after treatment. Controls were ten healthy normal subjects. All patients were treated with corticosteroid and beta-2 adrenergic agonist on admission. ET was determined by radioimmmunoassay and had 100% cross reactivity with ET-1, 67% with ET-2, 84% with ET-3, and 8% with Big-ET. Results : Plasma ETs were significantly elevated during acute attack of asthma compared with those in remission and controls.,However, there was no significant changes in urine ET concentrations or total ET amounts in 24 hour urine during exacerbation upto two weeks. Those levels of urine ET in asthmatics were still higher than controls. ET concentrations in plasma or urine were not correlated with pulmonary functional parameters and hypoxemia. Conclusion : The findings suggests that increased plasma ETs are related with exaggerated release during acute asthma. Urinary ET excretion is increased in asthma. However, urine ET changes during exacerbation should be observed in a larger and longer scale.

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The Role of Respiratory Viral Infections in Exacerbation of Asthma and Chronic Obstructive Pulmonary Disease (COPD) (천식 및 만성폐쇄성폐질환(COPD)의 악화에서 호흡기 바이러스 감염의 역할)

  • Yoo, Ji Youn;Kim, Dong-Gyu;Eom, Kwang-Seok;Shin, Taerim;Park, Yong Bum;Lee, Jae Young;Jang, Seung Hun;Bahn, Joon-Wo;Kim, Cheol Hong;Park, Sang Myeon;Lee, Myung Goo;Hyun, In-Gyu;Lee, Kyu Man;Jung, Ki-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.5
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    • pp.497-503
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    • 2005
  • Backgrounds : The exacerbations of asthma and chronic obstructive pulmonary disease (COPD) have been suggested to be associated with respiratory tract viral infections (RTVIs). However, the rates of virus detection in previous studies have been quite variable, with lower rates for the exacerbation of COPD. Therefore, the virus detection of patients with exacerbation of asthma and COPD were investigated. Methods : 20 and 24 patients with exacerbation of asthma and COPD, respectively, were enrolled. Nasal and sputum samples were taken, and polymerase chain reaction (PCR) for rhinovirus and coronavirus and virus culture for influenza A, B, RSV and parainfluenza virus performed. Results : The mean $FEV_1/FVC$ in the exacerbation of asthma and COPD patients were 1.9/2.9 L (65.5%) and 1.1/2.6 L (42.3%), respectively. Respiratory virus was detected in 13 (65%) patients with exacerbation of asthma and rhinovirus was detected in 9. Coronavirus, influenza A, RSV and parainfluenza virus were detected in 2, 2, 1 and 1 patients with asthma. Among patients with exacerbation of COPD, a virus was detected in 14 (58.3%) patients, with rhinovirus, coronavirus and influenza A detected in 10, 3 and 4, respectively. Conclusions : This study suggested that RTVIs may have a role in the exacerbation of COPD as well as asthma.

Circulating Levels of Interleukin-6 and Soluble Interleukin-6 Receptor in Acute Asthma (급성 천식환자에서 혈중 Interleukin-6 및 Soluble Interleukin-6 수용체의 변화)

  • Lee, Kyoung-Hoon;Lee, Yong-Chul;Cheon, Ki-Tae;Lee, Heung-Bum;Rhee, Yang-Keun
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.4
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    • pp.464-470
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    • 2000
  • Background : The recognition of bronchial asthma as an inflammatory disease led to the search for soluble markers that would be useful in assessing airway inflammation. Interleukin-6 (IL-6) is a representative proinflammatory cytokine that has been shown to be connected with various inflammatory diseases. IL-6 acts via specific receptors that consist of the IL-6 binding glycoprotein gp80 and the signal transducer gp130. In the search for markers of airway inflammation, delete the role of soluble interleukin-6 receptor (sIL-6R) and IL-6 in acute asthma were investigated. Methods : Serum levels of sIL-6R and IL-6 were measured in 78 acute asthmatics, in 15 patients with asymptomatic asthma and in 10 healthy control subjects by a specific ELISA using a murine antihuman IL-6R, IL-6 mAb ($Quantikine^{(R)}sIL$-6R, IL-6). Results : Serum levels of IL-6 in acute asthmatics significantly exceeded those of control subjects. The levels of sIL-6R in acute asthmatics were also significantly increased compared to those of control subjects. The serum concentrations of IL-6 obtained in acute asthmatics were elevated compared with those in asymptomatic asthmatics. However, association between eosinophilic count/IgE and IL-6/sIL-6R in acute asthma could not be found. Conclusion : Our results suggest that IL-6 may be involved in the pathogenesis of acute asthma, and serum levels of IL-6 and sIL-6R may reflect the severity of airway inflammation.

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Clinical Characteristics of Asthmatic Patients Who Visited Emergency Room (응급실로 내원한 천식환자들의 임상적 특성)

  • Suh, Jung-Kyung;Lee, So-Ra;Lee, Sang-Youb;Lee, Sang-Hwa;Cho, Jae-Youn;Shim, Jae-Jeong;In, Kwang-Ho;Kang, Kyung-Ho;Yoo, Se-Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.2
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    • pp.290-297
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    • 1997
  • Background : Despite remarkable progress of understanding the pathophysiology and therapy of bronchial asthma, asthma morbidity and mortality are on the rise. Also hospitalization and attending rates of emergency department for asthma have been increasing gradually. We analyzed clinical characteristics and prognosis of patients who visited emergency room due to asthma attack in order to define clinical characteristics of these group of patients. Method : We reviewed 105 adult asthmatic patients who attended emergency department of Korea University Hospital between August 1995 and July 1996, retrospectively. Results : 103 patients(56 female, 47 males, mean age : 48.6 years) attended-68 self referral, 18 practitioner referral and 17 OPD transfer- and 86 patients(83.5%) were admitted. Attending emergncy department was clearly more frequent in December(13.6%) and May(12.6%). Time lag between onset of asthmatic attack and arrival at the hospital was $14.2{\pm}15.5$ hour and initial peak expiratory flow rate was $166.7{\pm}68.3L/min$.(43.3% predicted) The commonest cause for visiting emergency room was aggravation of asthma due to upper respiratory tract infection in mild asthmatics. About half of them had history of previous ER visits. Their prognosis was not bad, but after discharge, about half of patients escaped from OPD follow-up. Conclusion : As a group they merit detailed attention and follow up arrangement. Clinician need to monitor and review the treatment plans, the medications, the patient's management technique, and the level of asthma control. For this group, plans for longer term treatment, including asthma education program and adjustment of overall treatment plan should be made.

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Respiratory Viral Infection and Bronchial Asthma (호흡기 바이러스 감염과 기관지 천식)

  • Hwang, Young-Sil;Lee, Jong-Deog
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.1
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    • pp.18-29
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    • 2000
  • 호흡기 바이러스 감염은 모든 연령층의 천식에 상당한 영향을 미치는 데 영아에서 RSV는 천명을 야기하고 대부분 일시적이나 재발성 일수도 있다. 어릴 때 바이러스 감염은 면역체계 형성에 영향를 미쳐 알러지와 천식의 위험을 완하할 수있다고 한다. 또한 소아와 성인 천식에서 RV같은 감기 바이러스는 천식의 급성 증상을 유발한다. 호흡기 바이러스 감염에 대한 면역반응이, 기관지로 부터 바이러스 제거 기능외에 기도수축과 호흡기 증상에 관여한다고 한다. 이러한 변화가 일어나는 기전은 호흡기 바이러스가 proinflammatory 사이토카인과 매개체 생성을 유도하는 능력과 연관성이 있는 것 같고 이들이 상하기도 호흡기 증상 및 기도반응 변화에 관여하는 것으로 생각된다. 호흡기 바이러스 감염에 대한 면역반응을 요약하면 바이러스 감염으로 상피세포, 내피세포, 과립백혈구가 활성화되며, 상피세포는 사이토카인, 키모카인, 매개체들을 분비하여 항 면역 반응를 주도하다. 이와 같은 상피세포와 다른 기관지 세포들의 조기 활성화로 내피 세포에 유착분자 표현을 증가시켜 백혈구 동원 증가 및 혈관 투과성을 증가시켜 부종과 분비물을 증가시킨다. 바이러스 또는 바이러스 유발 사이토카인에 의해 활성화된 과립 백혈구, 대식세포, T세포들도 기도염증 증가, 기도폐쇄를 야기하고 기도반응을 증가시킨다. 세포독성 임파구에 의한 바이러스 감염세포의 분해, TGF-$\beta$ IL-10 같은 사이토카인에 의해 부분적으로 염증억제, 기도 remoldeling에 의한 기도구조의 재생등이 바이러스 감염후 기관지 기능의 지속적 변화를 결정한다. 끝으로 천식환자에서 RV 감염의 병인에 관한 기본적 문제는 RV감염이 정상인에서는 경한 증상을 나타내는 데 천식환자에서는 왜 심한 임상증상을 나타내는지 아직 완전히 밝혀지지 않았다. 항 바이러스에 대한 면역반응이 천식환자에서 손상되었는지 또는 천식환자에서 RV감염에 의한 중증의 임상증상은 어떤 다른 세포가 관여하는지? 이들에 대한 답은 기도염증이 천식에서 어떻게 조절되는지 또한 바이러스 감염에 의한 악화된 증상을 어떻게 치료할 것인가에 대한 방향을 제시해줄 것이다.

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Influence of Yellow Sand Dust on the Distribution of $PM_{2.5}$ Concentrations in Seoul (서울시 일부지역에서의 $PM_{2.5}$ 농도에 대한 황사의 영향)

  • 백효경;김현욱;성재혁
    • Proceedings of the Korea Air Pollution Research Association Conference
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    • 2002.11a
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    • pp.199-201
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    • 2002
  • 입자상 물질은 폐렴으로 인한 사망률을 증가시키며, 호흡기 및 심혈관계 질환과 관련된 외래환자 수를 증가시키고, 천식 증상을 악화시키며, 폐 기능 저하 둥을 유발한다고 알려져 있다(U.S.EPA, 2001). 황사는 발원지의 기상 및 토양상태에 따라 다르지만 한반도와 일본에서 관측된 황사의 크기는 1-10$\mu\textrm{m}$ 정도이며 중금속 성분 등 오염물질이 포함되어 있어, 시정악화, 농작물 및 활엽수의 생육장애, 인체 호흡기관으로 깊숙이 침투하여 폐 질환 유발 및 안 질환 등을 유발시켜 대기환경을 오염시킬 뿐만 아니라 인체에도 매우 유해하다. (중략)

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Eotaxin mRNA Expression in Bronchial Mucosa of Patients with Asthma (천식 환자의 기관지 조직에서 Eotaxin mRNA 발현에 관한 연구)

  • In, Kwang-Ho;Cho, Jae-Yun;Kang, Sae-Yong;Lee, Sang-Youb;Shim, Jae-Jeong;Kang, Kyung-Ho;Yoo, Se-Hwa;Na, Young-Soon;Kim, Han-Gyum
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.4
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    • pp.697-704
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    • 1998
  • Background: Asthma is a chronic inflammatory disease of the airways characterized by a marked infiltration of eosinophils in the bronchial mucosa. Asthmatic bronchial mucosa produces many factors described as being chemotactic for inflammatory cells. IL-5, RANTES, and MCP-1 alpha are the chemotactic factors for eosinophils, but their roles are controversial. Recently eotaxin that is a potent eosinophil chemoattractant cytokine was detected in a guinea-pig model of allergic airway inflammation, and human eotaxin was cloned. Eotaxin is a specific chemoattractant for eosinophils, but its role in asthma is not confirmed. We examined the in vivo expression of eotaxin in bronchi of asthmatic patients. Methods : 11 asthmatics and 2 normal controls were enrolled. All subjects were underwent bronchoscopy with bronchial biopsies in 2nd or 3rd carina. RNA extraction from biopsy samples was done by acid-guanidium method. Semi-quantitaive RT-PCR was done for evaluation of eotaxin mRNA expression The extent of eosinophil infiltration was evaluated by counting the eosinophils in submucosa in HPF of microscope. Results : Eotaxin mRNA expressed in symptomatic, uncontrolled asthma. Steroid inhibited expression of eotaxin mRNA in asthma. Expression of eotaxin mRNA correlated with eosinophil infiltration in bronchial tissues. Conclusion: Expression of eotaxin mRNA increases in uncontrolled asthma and eotaxin is involved in the recruitment of eosinophils.

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